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in the ear canal. If the patient in general is troubled by a pulsatile tinnitus, this may indicate that further consultation
should be done to rule out a vascular middle-ear pathology.
•
Variations that are in synchrony with the patient's breathing:
This is a sign of Eustachian tube dysfunction and may .prevent further reflex testing.
•
Variations due to a very steep tympanogram (for example seen in excessively flaccid tympanic membranes):
This problem can usually be remedied by slightly offsetting the air pressure from the tympanometric peak pressure
(TPP). In case of a negative TPP, it is recommended that the pressure is offset further in the negative direction. In case
of a positive TPP, it is recommended that the pressure is offset further in the positive direction.
An offset of approximately 20 daPa is usually sufficient to stabilize the baseline. Note that excessive offsets will
decrease the threshold sensitivity by several dB.
Use the pressure offset button
use the dial to select the desired pressure.
Before testing
1. Do as described in
2. Inform the patient about the high stimulus levels in the test.
3. Ask the patient to sit very still and quiet during the test, without moving head or jaw.
4. If contralateral stimulation is used in the test, make sure that both the ipsilateral probe and the contralateral phone
are in place before you start the measurement.
5. If needed, toggle the
Testing
Warning
•
ured results are kept.
Starting the test
1. Press the
Y Recorder
2. Select
Y Recorder
3. The
4. Place the probe in the patient's ear.
5. Ask the patient to sit very still and quiet during the test, without moving
head or jaw.
Otometrics - MADSEN Zodiac
±P
to select a pressure offset to stabilize the eardrum. Keep the button depressed and
Preparing for testing ► 36
Ear Selector
to select the ear on which you wish to start the test.
If the patient is troubled by the test, stop the test. The test is interrupted immediately. Already meas-
Special
button.
.
view is shown.
9 Testing with Zodiac Diagnostic or Clinical - Stand-Alone
.
69
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